中枢神经损伤患者康复护理评估分析

The Role of Rehabilitation Nursing Evaluation in the Rehabilitation of the Patients with Central Nerve Injury

目的了解中枢神经损伤康复期患者存在的功能障碍、ADL 依赖程度和易发生的并发症。方法 2 70例中枢神经受损康复期患者根据病症分为 3组 (脑卒中组、脊髓损伤组和植物人组 ) ,然后进行康复护理、ADL 以及存在常见并发症的评估分析。结果 3组患者在意识、言语、感觉及吞咽障碍方面差异有显著性 (P<0 .0 1) ,在环境不适应、运动失衡方面差异有显著性 (P<0 .0 5 ) ;3组的 ADL 评估和并发症阳性率差异亦有显著性 (P<0 .0 1)。植物人组 ADL为完全依赖 ,脑卒中组 ADL的自理能力高于其它 2组 ;植物人组存在意识、言语、感觉及吞咽障碍 ,运动失衡等 ,易发生皮肤压红、呛咳、肌肉萎缩、肺炎、尿路感染及二便失禁 ;脑卒中组除了具有植物人的特点外 ,环境不适应问题更为明显 ,易并发肩痛、跌倒 ;而脊髓损伤组存在感觉障碍、运动失衡及精神症状 ,其尿路感染、二便失禁更为突出。结论中枢神经损伤患者在临床急性期即进行康复护理评估 ,有助于早期康复护理的介入 ,减少并发症 ,加强患者整体康复的进程。

Objective\ To investigate the dysfunction, the dependence of ADL and the complications in the patients with central nerve injury at the early stage of rehabilitation Methods\ 270 patients with central nerve injury at the early stage of rehabilitation were randomly divided into three groups in terms of disease conditions: group I, stroke; Ⅱ, spinal injury; group Ⅲ, persistent vegetative state (PVS) The rehabilitation nursing, ADL and ordinary complications were evaluated and analyzed Results\ There was statistically significant difference in consciousness disorder, language disorder, feeling disorder and deglutition disorder among the three groups ( P <0 05) There was very significant difference in ADL evaluation and the complication rate among the three groups ( P <0 01) Conclusion\ The PVS patients were ADL completely dependent The ability of taking of onself in ADL in the patients with stroke was stronger than in PVS and spinal injury Meanwhile PVS patients had conciousness dys, language dys, feeling dys, deglutition dys and movement unbalance, easily suffering from rebicund skin, choke cough, muscle atrophy, pneumonia, urinary tract infection, incontinence of excrement and pee The stroke patients had the same characters that the PVS patients had The major problem was that they had maladjustment environment, easily suffering from omalgia and tumble The patients with spinal injury had feeling dys, movement unbalance, mental symptom, urinary tract infection, incontinence of extrement and pee